Chronic kidney disease (CKD) is a prevalent ailment in aging dogs. One of the most emotionally draining challenges that dog owners and veterinarians face in managing this condition is the loss of appetite in affected dogs. I’ve heard owners say… “I feel defeated” when recounting the daily struggle of trying to get their dog to eat.
Until someone has walked this path it’s hard to comprehend how draining this can be. This is the number one question I am asked: “How Can I Get My Dog To Eat!?” This article discusses the reasons behind this reduced appetite, possible solutions, and perspectives from both Western and Traditional Chinese Medicine (TCM). I will also explore the role of the body clock and why appetite might pick up in the evening.
Reasons for Appetite Loss in Dogs with CKD
- Uremic toxins: As the kidney function declines, the body is unable to effectively remove toxins and waste products, which accumulate in the bloodstream. These uremic toxins can lead to nausea, vomiting, and a decreased appetite in dogs with CKD.
- Gastric ulcers: Dogs with CKD are more prone to developing gastric ulcers due to the high urea levels in their blood. These ulcers can cause pain and discomfort, contributing to a lack of appetite.
- Anemia: Kidneys are responsible for producing erythropoietin, a hormone that stimulates red blood cell production. In dogs with CKD, the reduced kidney function leads to lower erythropoietin levels, causing anemia. Anemia can result in weakness, lethargy, and decreased appetite.
- Oral health issues: Dogs with CKD may experience oral health issues such as bad breath, mouth ulcers, and gum inflammation, which can all contribute to a decreased appetite.
Possible Solutions
- Appetite stimulants: Veterinarians may prescribe appetite stimulants to help increase food intake by improving appetite and alleviating nausea.
- Dietary modifications: A diet designed for dogs with kidney disease is typically low in phosphorus, protein, and sodium. This specialized diet can help alleviate symptoms and slow the progression of CKD. Warming the food or adding low-sodium broth may also make it more appealing to dogs.
- Smaller, frequent meals: Feeding dogs smaller portions more frequently throughout the day can help keep their energy levels stable and improve their appetite.
TCM Perspective
In Western medicine, the focus is primarily on symptom management and slowing the progression of CKD. Treatments include medications, dietary modifications, and fluid therapy.
In contrast, Traditional Chinese Medicine (TCM) takes a holistic approach to treating CKD by addressing the underlying imbalances in the body.
The kidneys are associated with both Yin and Yang energies. The Kidney Yin and Kidney Yang energies are considered to be complementary and interconnected, and an imbalance in either one can lead to health issues, including CKD.
Kidney Yin refers to the fluid, nourishing aspect of the kidneys, and is responsible for cooling, moistening, and nourishing the body. Kidney Yang, on the other hand, refers to the warming and activating aspect of the kidneys and is responsible for providing energy to the body’s organs and tissues.
A TCM practitioner can determine if a dog with CKD has a deficiency in Kidney Yin, Kidney Yang, or both by taking a thorough medical history and performing a physical examination, including feeling the dog’s pulse and observing their tongue.
Signs of Kidney Yin deficiency in dogs may include dry mouth, thirst, weakness, loss of appetite, and a red tongue with little coating. Signs of Kidney Yang deficiency may include cold extremities, lethargy, incontinence, and a pale tongue with a thick coating.
A TCM practitioner may use a combination of acupuncture, herbal remedies, and dietary modifications to address the underlying imbalances and support the kidneys’ functions, depending on the specific diagnosis. Acupuncture can stimulate the flow of Qi and Blood, while herbs such as Rehmannia and Cornus can nourish Kidney Yin. Herbs such as Cinnamon and Dried Ginger can warm and activate Kidney Yang. Dietary modifications may involve feeding the dog warming, easily digestible foods, such as lean meats and cooked vegetables.
It’s important to note that a TCM diagnosis and treatment plan be provided by a TCVM vet. It’s easy to find out what herbs another dog might be taking and buy it on Amazon but different herbs have different mechanisms. Some move blood flow to the kidneys and some move blood flow away from the kidneys. I will share my TCVM vet’s contact information below (he does phone consults).
Holistic Health Care for Pets
1707 E. 11th Ave, Spokane WA 99202
Call: 509-214-2676
If you would like to contact him via email: DrThomasHolisticvet@yahoo.com
I use him for my own dogs, and refer clients to him when a TCVM vet isn’t available in your city.
Body Clock and Appetite Changes
Just like humans, dogs have an internal body clock called the circadian rhythm, which influences various physiological processes, including appetite. In the evening, dogs with CKD may experience an increase in appetite due to several reasons.
Firstly, hormonal changes in the body, such as fluctuations in cortisol and melatonin levels, can affect appetite. When cortisol levels decrease and melatonin levels increase in the evening, dogs may experience an increase in appetite.
Secondly, environmental cues, such as associating evening with mealtime or treats, can also lead to an increase in appetite in dogs.
Lastly, dogs with CKD may conserve energy during the day due to weakness and lethargy, resulting in them feeling more energetic in the evening and thus, an increased appetite.
In TCM, the circadian rhythm plays a significant role in regulating bodily functions, including appetite. TCM theory suggests that the body’s Qi and Blood flow through different meridians or pathways at specific times of the day, with each meridian associated with a specific organ system.
The Spleen and Stomach meridians, which are most active during the daytime hours, are closely connected to the digestive system in TCM theory. Dogs with CKD who have a decreased appetite in the morning may have an imbalance in the Spleen and Stomach meridians, leading to poor digestion and sluggish metabolism.
In contrast, the Kidney meridian, which is responsible for nourishing the body’s fluids and supporting the digestive system’s function, is most active during the evening hours. Dogs with CKD may experience an increase in appetite in the evening as their Kidney meridian becomes more active, leading to an improvement in digestion and a boost in energy.
Overall, from a TCM perspective, an imbalance in the Spleen and Stomach meridians and a deficiency in Kidney Yin and Yang energies can contribute to the decreased appetite in the morning and the increased appetite in the evening that dogs with CKD may experience.

Dietary Modifications
Luckily, dogs with CKD can benefit immensely from modifications to their diet when they:
- Move to fresh food (cooked or raw) and get off kibble
- Fed quality protein
- Fed reduced protein (in a fresh food diet I target around 2x AAFCO’s RDA in DM)
- Low- phosphorus diets
- Controlled sodium diets
- Nutritional Supplements: Supplements such as omega-3 fatty acids, B vitamins, and antioxidants can help support kidney function and improve the dog’s overall health
- Chinese Herbs as prescribed by TCVM vet
Subcutaneous (Sub Q) fluids should also be given to dogs with CKD regardless of what stage they are in.
The Role Of Emotions in CKD
In Traditional Chinese Medicine (TCM), emotions are considered an essential aspect of health and well-being. Emotions can affect the functioning of the body’s organs and meridians, leading to various physical and mental health conditions.
For dogs with (CKD), TCM considers emotions to play an important role in the development and progression of the disease. The Kidneys are considered to be the root of the body’s Yin and Yang energies and are associated with the emotion of fear.
Excessive or chronic fear can weaken the Kidney Qi, leading to imbalances in the body’s Yin and Yang energies, which can result in various health conditions, including CKD. Similarly, other negative emotions such as anger, sadness, and worry can also affect the body’s organ systems, leading to imbalances and contributing to the progression of CKD.
And I’m not just referring to the energy of the dog because the owner’s energy also impacts and influences how the dogs feel.
In TCM, the goal of treatment for CKD is to restore the balance of Yin and Yang energies and strengthen the Kidney Qi.
I often explain that energy is part of the healing process and when I sense that it is needed will provide some energy guidance as well. To truly help, dog owners should cultivate positive emotions such as joy and contentment and avoid excessive or chronic negative emotions.
In Closing
The lose of appetite can be a gut-wrenching side effect in dogs with CKD.
My number one recommendation is to manage your energy and follow a feeding plan. By working with at TCVM vet or a nutritionist such as myself we can help lift this emotional burden by providing you with a roadmap on how to navigate how to feed your dog.
As always, thank you for stopping by. And I wish you and your dog good Health!

Author Biography
Hannah Zulueta obtained her Certificate in Canine Nutrition from CASI Institute. She is also studying for her Doctorate in Acupuncture, Traditional Chinese Medicine, and Herbalism from the esteemed Pacific College of Health and Medicine.
She resides in San Diego with her three dogs, Maggie, Orbit, and Mr. Higgins.
She is available for one on one consultations. Additionally, you can find her sharing free content on Instagram.